Module 9 Part 2 Vaginitis Trichomoniasis

Question 1

Is treatment necessary for all cases of trichomoniasis (vaginitis)?

Answer 1

Yes, all cases and their sexual partners should be treated regardless of symptoms.

Question 2

What is the preferred treatment for symptomatic trichomoniasis?

Answer 2

Metronidazole, either as a single oral dose of 2 grams or 500 mg twice a day for 7 days.

Question 3

Can trichomoniasis be asymptomatic, and how common is this?

Answer 3

Yes, many patients (10-50%) with trichomoniasis may not show symptoms.

Question 4

How is trichomoniasis treated during pregnancy, and when is treatment recommended?

Answer 4

Treatment is recommended if symptomatic during pregnancy. A single oral dose of 2 grams of metronidazole is an effective treatment.

Question 5

What should lactating women consider when taking metronidazole?

Answer 5

Metronidazole enters breast milk but is not contraindicated during breastfeeding. Withholding breastfeeding during treatment and for 12–24 hours after the last dose can reduce infant exposure to metronidazole. Avoid high doses if breastfeeding.

Question 6

Is treatment necessary for asymptomatic bacterial vaginosis (BV)?

Answer 6

Generally, no, unless there are specific circumstances, such as a high-risk pregnancy.

Question 7

When is treatment for symptomatic BV necessary during pregnancy?

Answer 7

It is recommended in pregnancy, especially in high-risk pregnancies, but should be carefully considered, and oral metronidazole use in the first trimester may be avoided.

Question 8

What are the first-line treatment options for symptomatic BV?

Answer 8

Metronidazole (oral or vaginal) and Clindamycin 2% cream.

Question 9

How is recurrent BV treated?

Answer 9

Recurrent BV is treated with extended courses of metronidazole (oral or vaginal).

Question 10

What is the role of Lactobacilli preparations in BV treatment?

Answer 10

Lactobacilli preparations are used but have limited evidence for their effectiveness in BV